Neutrophil Gelatinase-Associated Lipocalin Attenuates Ischemia/Reperfusion Injury in an In Vitro Model via Autophagy Activation.

BACKGROUND The aim of this study was to investigate the protective effects of neutrophil gelatinase-associated lipocalin (NGAL) on hypoxia/reoxygenation (H/R) induced acute kidney injury (AKI) in vitro. MATERIAL AND METHODS We used NRK-52E cells and H/R treatments to mimic ischemia/reperfusion injury (IRI) in vitro. Experimental groups were: the control group, the H/R group, the 3-methyladenine (3-MA)+H/R group, the NGAL (0.25, 0.5, and 1 ug/mL)+H/R group, and the NGAL (0.25, 0.5, 1 ug/mL)+3-MA+H/R group. After 24 hours of culture, cell proliferation was analyzed by CCK-8 assay. Expression of LC3-II was detected by immunoblot assay. Autophagy was detected by electron microscopy. RESULTS The expression of LC3-II was increased in the H/R group compared with normoxic condition (p<0.05) and proliferation also improved. Autophagy was significantly inhibited by 3-MA, with downregulated of LC3-II, followed by decreased cell viability (p<0.05). We further detected the effect of different doses of NGAL in H/R induced injury, and found that low doses of NGAL alone slightly increased LC3-II protein accumulation, and autophagy was further induced with higher dose of NGAL treatment. Meanwhile, cell viability assays showed induced cell survival. We found that in the NGAL+3-MA group, cell viability assays revealed reduced cell damage, followed concomitantly with depressed autophagy. The formulation of autophagosomes were correlated with LC3-II protein expression in each group. CONCLUSIONS Autophagy plays a renoprotective role in H/R injury, as well in AKI. NGAL might be related to attenuated tubular epithelial cell damage via adjusting autophagy.

Combined detection of procalcitonin and endotoxin in early diagnosis of urosepsis after percutaneous neph-rolithotomy / 医学研究生学报

[Abstract ] Objective At present, few studies are reported on procalciton (PCT) and endotoxin (ET) in the diagnosis of urosepsis after percutaneous nephrolithotomy ( PCNL) .The purpose of this study was to investigate the clinical value of the detection of serum procalcitonin and endotoxin in the early diagnosis of urosepsis after PCNL . Methods We retrospectively analyzed the clinical data about 427 cases of upper urinary tract stones treated by PCNL , among which urosepsis developed postoperatively in 49 ( the urosepsis group ) and the other 378 non-urosepsis cases served as controls .At 1 day and 2 hours before PCNL , we detected the levels of serum ET and PCT and analyzed the PCT and ET levels and the results of combined detection in the two groups of patients using the ROC curve. Results At 2 hours before surgery , both the levels of PCT and ET were significantly higher in the urosepsis group than in the non-urosepsis controls ([ 5.18 ±4.43 ] vs [ 1.38 ±1.01 ] ng/mL, P<0.01;[50.91 ±35.45] vs [17.86 ±10.78] pg/mL, P<0.01).ROC curve analyses manifested that the areas under the curve (AUC) of PCT and ET were 0.841 ±0.038 and 0.786 ± 0.043, their sensitivities were 79.6%and 71.4%, and their specificities were 78.0%and 70.1%, respectively.The combined de-tection showed the AUC, sensitivity, and specificity to be 0.915 ±0.029, 85.7%, and 86.5%, respectively, all significantly higher than either PCT or ET detection alone (P<0.01). Conclusion The combined detection of PCT and ET can significantly increase the sensitivity and specificity of early diagnosis of urosepsis after PCNL and is superior to either PCT or ET detection alone .